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Eichenauer H, Ehlert U. The association between prenatal famine, DNA methylation and mental disorders: a systematic review and meta-analysis. Clin Epigenetics 2023; 15:152. [PMID: 37716973 PMCID: PMC10505322 DOI: 10.1186/s13148-023-01557-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/14/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Undernutrition in pregnant women is an unfavorable environmental condition that can affect the intrauterine development via epigenetic mechanisms and thus have long-lasting detrimental consequences for the mental health of the offspring later in life. One epigenetic mechanism that has been associated with mental disorders and undernutrition is alterations in DNA methylation. The effect of prenatal undernutrition on the mental health of adult offspring can be analyzed through quasi-experimental studies such as famine studies. The present systematic review and meta-analysis aims to analyze the association between prenatal famine exposure, DNA methylation, and mental disorders in adult offspring. We further investigate whether altered DNA methylation as a result of prenatal famine exposure is prospectively linked to mental disorders. METHODS We conducted a systematic search of the databases PubMed and PsycINFO to identify relevant records up to September 2022 on offspring whose mothers experienced famine directly before and/or during pregnancy, examining the impact of prenatal famine exposure on the offspring's DNA methylation and/or mental disorders or symptoms. RESULTS The systematic review showed that adults who were prenatally exposed to famine had an increased risk of schizophrenia and depression. Several studies reported an association between prenatal famine exposure and hyper- or hypomethylation of specific genes. The largest number of studies reported differences in DNA methylation of the IGF2 gene. Altered DNA methylation of the DUSP22 gene mediated the association between prenatal famine exposure and schizophrenia in adult offspring. Meta-analysis confirmed the increased risk of schizophrenia following prenatal famine exposure. For DNA methylation, meta-analysis was not suitable due to different microarrays/data processing approaches and/or unavailable data. CONCLUSION Prenatal famine exposure is associated with an increased risk of mental disorders and DNA methylation changes. The findings suggest that changes in DNA methylation of genes involved in neuronal, neuroendocrine, and immune processes may be a mechanism that promotes the development of mental disorders such as schizophrenia and depression in adult offspring. Such findings are crucial given that undernutrition has risen worldwide, increasing the risk of famine and thus also of negative effects on mental health.
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Affiliation(s)
- Heike Eichenauer
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050, Zurich, Switzerland.
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2
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Bax OK, Chartonas D, Parker J, Symniakou S, Lee T. Personality disorder. BMJ 2023; 382:e050290. [PMID: 37666510 DOI: 10.1136/bmj-2019-050290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Affiliation(s)
- Orestis Kanter Bax
- Basildon Complex Needs Psychotherapy and Personality Disorder Service, Essex Partnership University NHS Foundation Trust, UK
- Centre for Understanding Personality (CUSP), London
| | - Dimitrios Chartonas
- Centre for Understanding Personality (CUSP), London
- Camden and Islington Personality Disorder Service, Camden and Islington NHS Foundation Trust
| | - Jennie Parker
- Centre for Understanding Personality (CUSP), London
- Berkshire Healthcare NHS Foundation Trust
| | | | - Tennyson Lee
- Centre for Understanding Personality (CUSP), London
- Deancross Personality Disorder Service, East London NHS Foundation Trust
- Institute of Psychoanalysis, British Psychoanalytical Society
- Blithdale Health Centre, Clinical Director East End Health Network
- Wolfson Institute, Queen Mary University of London
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Burgess A, Breman RB, Roane LA, Dada S, Bradley D, Burcher P. Impact of COVID-19 on pregnancy worry in the United States. Birth 2022; 49:420-429. [PMID: 34997646 DOI: 10.1111/birt.12608] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Several recent studies confirm that the COVID-19 pandemic has increased symptoms of stress, anxiety, and depression in pregnant persons around world. In this study, we aimed to uncover the impact of COVID-19 on worry during pregnancy. METHODS This study used a cross-sectional descriptive research design. A link to a survey was emailed to users of the Ovia Pregnancy app. Participants (N = 253) completed the survey, which included the Cambridge Worry in Pregnancy Scale, and answered several free text questions. The free-text questions were included to capture worries not listed on the scale and to allow participants the opportunity to more clearly describe COVID-19-related worries. Descriptive statistics were reported, and content analysis performed to determine themes. RESULTS Overall, respondents reported they were quite or very worried about having their partner with them at birth (31.7%, n = 80), giving birth (28.2%; n = 71), and something being wrong with the baby (27.3%; n = 69). Results on worries also differed by participants' race, parity, and trimester. When comparing White to other racial groups, other racial groups had statistically significantly higher median scores for questions on worries about employment (P = .001), going to the hospital (P = .002), and internal examinations (P = .03). Content analysis revealed isolation, loss of support, anxiety/stress, and grief as major themes. DISCUSSION The worry, isolation, loss of support, anxiety, and grief reported by pregnant persons during the COVID-19 pandemic may impact maternal pre- and postnatal mental health and are not borne equally. Birthing persons of color appear disproportionately impacted. Prenatally, maternity care providers should assess for worry and provide individualized education and resources to pregnant patients, centering individuals and communities made most vulnerable by structural inequality.
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Affiliation(s)
- Adriane Burgess
- Women and Children Service Line, WellSpan Health, York, Pennsylvania, USA
| | | | - Lynnee A Roane
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
| | - Sophia Dada
- University of Maryland, College Park, Maryland, USA
| | - Dani Bradley
- Clinical Affairs, Ovia Health, Boston, Massachusetts, USA
| | - Paul Burcher
- WellSpan York Hospital, York, Pennsylvania, USA.,Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.,Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
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4
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McKay MT, Healy C, Chambers D, Dodd P, O'Donnell L, Cannon M, Clarke MC. The Subjective Impact and Timing of Adversity Scale: A Feasibility Study Using Cross-Sectional and Longitudinal Data. Assessment 2022:10731911221116573. [PMID: 35996849 DOI: 10.1177/10731911221116573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study assessed the feasibility of a multi-domain measure of the occurrence, impact, and timing of childhood/adolescent psychological adversity exposure, the Subjective Impact and Timing of Adversity Scale (SITA). Participants were from among those who had previously participated in two waves of data collection when aged approximately 14 and 21 years. Internal consistency estimates at both online and interview stages were acceptable for all SITA domains (with the exception of parental loss). SITA domain scores correlated meaningfully with scores on other scales and psychological measures, supporting convergent validity. Those with lifetime psychiatric diagnoses scored significantly higher on SITA domains than those not meeting diagnostic threshold. There was evidence of the importance of both the subjective impact and timing of adversity with regard to psychiatric diagnoses. The study demonstrates the viability of the SITA; however, further studies are required to substantiate these findings in larger samples.
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Affiliation(s)
- Michel T McKay
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Colm Healy
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | - Laurie O'Donnell
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Mary Cannon
- RCSI University of Medicine and Health Sciences and Beaumont Hospital, Dublin, Ireland
| | - Mary C Clarke
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
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5
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Razavinasab M, Parsania S, Nikootalab M, Khaleghi M, Saleki K, Banazadeh M, Shabani M. Early environmental enrichment prevents cognitive impairments and developing addictive behaviours in a mouse model of prenatal psychological and physical stress. Int J Dev Neurosci 2022; 82:72-84. [PMID: 34845740 DOI: 10.1002/jdn.10161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/05/2021] [Accepted: 11/19/2021] [Indexed: 11/12/2022] Open
Abstract
Environmental enrichment (EE) has shown remarkable effects in improving cognition and addictive behaviour. We tested whether EE could help recover from prenatal stress exposure. Mature Swiss Webster male and virgin female mice were placed together until vaginal plugs were detectable. Next, pregnant rodents were randomized into the control, physically and psychologically stressed groups. The application of stress was initiated on the 10th day of pregnancy and persisted for a week to induce stress in the mice. Open field and elevated plus-maze (EPM) tests were utilized as explorative and anxiety assays, respectively. A passive avoidance shuttle-box test was carried out to check anxiety-modulated behaviour. Morris water maze (MWM) test was undertaken to evaluate spatial learning and memory. Conditioned place preference (CPP) test was selected for evaluation of tendency to morphine consumption. Our results showed that prenatal stress elevated anxiety-like behaviour in the offspring which EE could significantly alleviate after weaning. We also found a higher preference for morphine use in the physical stress and psychological stress offspring group. However, no difference was observed among the genders. Application of EE for the stress group improved several parameters of the cognitive behaviour significantly. Although prenatal stress can lead to detrimental behavioural and cognitive outcomes, it can in part be relieved by early exposure to EE. However, some outcomes linked to prenatal stress exposure may not be diminished by EE therapy. In light of such irreversible effects, large-scale preventive actions promoting avoidance from stress during pregnancy should be advised.
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Affiliation(s)
- Moazamehosadat Razavinasab
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahnaz Parsania
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahdi Nikootalab
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Mina Khaleghi
- Department of Physiology, Kerman University of Medical Sciences, Kerman, Iran
| | - Kiarash Saleki
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
- USERN Office, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Banazadeh
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Shabani
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
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Perinatal foundations of personality pathology from a dynamical systems perspective. Curr Opin Psychol 2020; 37:121-128. [PMID: 33444894 DOI: 10.1016/j.copsyc.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/17/2020] [Accepted: 12/07/2020] [Indexed: 11/21/2022]
Abstract
The development of personality pathology is an interactive process between biologically based susceptibilities, interpersonal patterns, and contextual factors across the lifespan. In this paper, we argue that these interactions begin before birth. We describe the perinatal period (i.e. pregnancy and up to one year postpartum) as a sensitive developmental window during which regulatory and stress response systems that confer risk for personality pathology begin forming. In addition, we present converging evidence for significant associations between perinatal factors and later life personality disorders. Finally, we present this perinatal perspective through the lens of dynamical systems theory and emphasize the promise of this framework for guiding future personality disorder research, prevention, and intervention.
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Brown G, Ginestet CE. Response to the article 'The role of prenatal stress as a pathway to personality disorder: longitudinal birth cohort study'. Br J Psychiatry 2020; 217:727. [PMID: 33250062 DOI: 10.1192/bjp.2020.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Gillian Brown
- Psychiatry core trainee, South London and Maudsley NHS Foundation Trust, UK
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8
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Brannigan R, Clarke M. Authors' reply. Br J Psychiatry 2020; 217:728. [PMID: 33250064 DOI: 10.1192/bjp.2020.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ross Brannigan
- PhD candidate, Royal College of Surgeons in Ireland, Ireland
| | - Mary Clarke
- Senior Lecturer, Royal College of Surgeons in Ireland, Ireland
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9
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Tavares A, McAlpine L. Re: 'The role of prenatal stress as a pathway to personality disorder'. Br J Psychiatry 2020; 217:727. [PMID: 33250065 DOI: 10.1192/bjp.2020.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Amanda Tavares
- medical student, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Lynsey McAlpine
- psychiatric higher trainee, East London Foundation Trust, UK.
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10
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Reddaway J, Brydges NM. Enduring neuroimmunological consequences of developmental experiences: From vulnerability to resilience. Mol Cell Neurosci 2020; 109:103567. [PMID: 33068720 PMCID: PMC7556274 DOI: 10.1016/j.mcn.2020.103567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 09/14/2020] [Accepted: 10/12/2020] [Indexed: 12/14/2022] Open
Abstract
The immune system is crucial for normal neuronal development and function (neuroimmune system). Both immune and neuronal systems undergo significant postnatal development and are sensitive to developmental programming by environmental experiences. Negative experiences from infection to psychological stress at a range of different time points (in utero to adolescence) can permanently alter the function of the neuroimmune system: given its prominent role in normal brain development and function this dysregulation may increase vulnerability to psychiatric illness. In contrast, positive experiences such as exercise and environmental enrichment are protective and can promote resilience, even restoring the detrimental effects of negative experiences on the neuroimmune system. This suggests the neuroimmune system is a viable therapeutic target for treatment and prevention of psychiatric illnesses, especially those related to stress. In this review we will summarise the main cells, molecules and functions of the immune system in general and with specific reference to central nervous system development and function. We will then discuss the effects of negative and positive environmental experiences, especially during development, in programming the long-term functioning of the neuroimmune system. Finally, we will review the sparse but growing literature on sex differences in neuroimmune development and response to environmental experiences. The immune system is essential for development and function of the central nervous system (neuroimmune system) Environmental experiences can permanently alter neuroimmune function and associated brain development Altered neuroimmune function following negative developmental experiences may play a role in psychiatric illnesses Positive experiences can promote resilience and rescue the effects of negative experiences on the neuroimmune system The neuroimmune system is therefore a viable therapeutic target for preventing and treating psychiatric illnesses
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Affiliation(s)
- Jack Reddaway
- Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ, UK
| | - Nichola M Brydges
- Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ, UK.
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11
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Environmental regulation of the chloride transporter KCC2: switching inflammation off to switch the GABA on? Transl Psychiatry 2020; 10:349. [PMID: 33060559 PMCID: PMC7562743 DOI: 10.1038/s41398-020-01027-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 12/15/2022] Open
Abstract
Chloride homeostasis, the main determinant factor for the dynamic tuning of GABAergic inhibition during development, has emerged as a key element altered in a wide variety of brain disorders. Accordingly, developmental disorders such as schizophrenia, Autism Spectrum Disorder, Down syndrome, epilepsy, and tuberous sclerosis complex (TSC) have been associated with alterations in the expression of genes codifying for either of the two cotransporters involved in the excitatory-to-inhibitory GABA switch, KCC2 and NKCC1. These alterations can result from environmental insults, including prenatal stress and maternal separation which share, as common molecular denominator, the elevation of pro-inflammatory cytokines. In this review we report and systemize recent research articles indicating that different perinatal environmental perturbations affect the expression of chloride transporters, delaying the developmental switch of GABA signaling, and that inflammatory cytokines, in particular interleukin 1β, may represent a key causal factor for this phenomenon. Based on literature data, we provide therefore a unifying conceptual framework, linking environmental hits with the excitatory-to-inhibitory GABA switch in the context of brain developmental disorders.
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12
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Brydges NM, Reddaway J. Neuroimmunological effects of early life experiences. Brain Neurosci Adv 2020; 4:2398212820953706. [PMID: 33015371 PMCID: PMC7513403 DOI: 10.1177/2398212820953706] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/07/2020] [Indexed: 12/18/2022] Open
Abstract
Exposure to adverse experiences during development increases the risk of psychiatric illness later in life. Growing evidence suggests a role for the neuroimmune system in this relationship. There is now substantial evidence that the immune system is critical for normal brain development and behaviour, and responds to environmental perturbations experienced early in life. Severe or chronic stress results in dysregulated neuroimmune function, concomitant with abnormal brain morphology and function. Positive experiences including environmental enrichment and exercise exert the opposite effect, promoting normal brain and immune function even in the face of early life stress. The neuroimmune system may therefore provide a viable target for prevention and treatment of psychiatric illness. This review will briefly summarise the neuroimmune system in brain development and function, and review the effects of stress and positive environmental experiences during development on neuroimmune function. There are also significant sex differences in how the neuroimmune system responds to environmental experiences early in life, which we will briefly review.
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Affiliation(s)
- Nichola M Brydges
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Jack Reddaway
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
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13
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Brannigan R, Tanskanen A, Huttunen MO, Cannon M, Leacy FP, Clarke MC. The role of prenatal stress as a pathway to personality disorder: longitudinal birth cohort study - CORRIGENDUM. Br J Psychiatry 2020; 216:285. [PMID: 32041678 DOI: 10.1192/bjp.2020.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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14
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Anderson G, Maes M. Gut Dysbiosis Dysregulates Central and Systemic Homeostasis via Suboptimal Mitochondrial Function: Assessment, Treatment and Classification Implications. Curr Top Med Chem 2020; 20:524-539. [DOI: 10.2174/1568026620666200131094445] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 02/08/2023]
Abstract
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The gut and mitochondria have emerged as two important hubs at the cutting edge of research
across a diverse array of medical conditions, including most psychiatric conditions. This article highlights
the interaction of the gut and mitochondria over the course of development, with an emphasis on
the consequences for transdiagnostic processes across psychiatry, but with relevance to wider medical
conditions. As well as raised levels of circulating lipopolysaccharide (LPS) arising from increased gut
permeability, the loss of the short-chain fatty acid, butyrate, is an important mediator of how gut dysbiosis
modulates mitochondrial function. Reactive cells, central glia and systemic immune cells are also
modulated by the gut, in part via impacts on mitochondrial function in these cells. Gut-driven alterations
in the activity of reactive cells over the course of development are proposed to be an important determinant
of the transdiagnostic influence of glia and the immune system. Stress, including prenatal stress,
also acts via the gut. The suppression of butyrate, coupled to raised LPS, drives oxidative and nitrosative
stress signalling that culminates in the activation of acidic sphingomyelinase-induced ceramide. Raised
ceramide levels negatively regulate mitochondrial function, both directly and via its negative impact on
daytime, arousal-promoting orexin and night-time sleep-promoting pineal gland-derived melatonin.
Both orexin and melatonin positively regulate mitochondria oxidative phosphorylation. Consequently,
gut-mediated increases in ceramide have impacts on the circadian rhythm and the circadian regulation of
mitochondrial function. Butyrate, orexin and melatonin can positively regulate mitochondria via the disinhibition
of the pyruvate dehydrogenase complex, leading to increased conversion of pyruvate to acetyl-
CoA. Acetyl-CoA is a necessary co-substrate for the initiation of the melatonergic pathway in mitochondria
and therefore the beneficial effects of mitochondria melatonin synthesis on mitochondrial function.
This has a number of treatment implications across psychiatric and wider medical conditions, including
the utilization of sodium butyrate and melatonin.
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Overall, gut dysbiosis and increased gut permeability have significant impacts on central and systemic
homeostasis via the regulation of mitochondrial function, especially in central glia and systemic immune
cells.
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Affiliation(s)
- George Anderson
- CRC Scotland & London, Eccleston Square, London, United Kingdom
| | - Michael Maes
- Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand
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